Report Catalogs the Challenges and Looks to Assist Early Career Academic Cardiologists

Apr 02, 2014

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The early career professional member section of the ACC has issued a white paper designed to inform the cardiovascular medical community regarding a growing number of challenges facing today's young academic cardiologists, presenting data on perceived obstacles, and providing possible solutions to the plight. The report was published April 2 in the Journal of the American College of Cardiology.

According to the investigation, early career academic cardiologists — defined as physician-scientists, scientist-researchers, clinician-educators, clinician-educator-administrators, and pure clinicians — are prone to a number of difficulties sustaining their professional pathway. Recent cuts in research support, pending cuts in graduate medical education, and a decline in reimbursements for clinical activities all threaten this vulnerable career phase. Left unchecked, this present reality is poised to make the nation progressively ill-equipped to meet a rapidly expanding health care need, jeopardizing the country's longstanding predominance in health care research and innovation in the process.

Another issue early career academic cardiologists must navigate is that the practice of clinical medicine requires many years of preparation, often involving the achievement of both MD and PhD degrees. While skills are still in development, it is not uncommon for an academic cardiologist to assume a first faculty position in his or her late thirties.

Looking to gain a better perspective of the active environment affecting early career academic cardiologists, the ACC conducted an online survey of 2,957 randomly selected individuals included in its early career member section between September and October of 2013. The results of the outreach found that the vast majority of respondents (88 percent) strongly believed that physicians need to lead or be a part of health care research. The respondents however, identified a litany of challenges facing such a goal, with 78 percent pointing to a lack of time, 73 percent to unstable funding, 72 percent to burdensome regulatory compliance, 69 percent to the disadvantages of competing against pure PhDs, 62 percent to an over-emphasis on relative value unit-based metrics of performance which can discourage academic pursuits, and 52 percent to insufficient support from the home institution. The vast majority of respondents (92 percent) reported insufficient external funding as a major challenge in obtaining a stable academic career.

A number of potential solutions were presented for early academic cardiologists, including improvements to fellowship training, including a better allocation of dedicated research time; developing novel partnership and alternative funding sources, such as with an university system or clinical entity; and seeking overall policy changes, better educating the public, elected representatives and regulatory officials of medical education and research's critical importance.

"One of the things the Early Career Member Section regularly does is reach out to its members and ask how we can help, and how we can make our professional lives easier and better," said Andrew Freeman, MD, FACC, chair of the ACC Early Career Section Leadership Council. "At our section meeting last year, Carl Tong, MD, PhD, FACC, stepped up to voice concerns about issues facing early career professionals in academics and I engaged with him to start an academic workgroup of our council. From there, we surveyed our members in academics, gathered data, and discovered some alarming trends in academia that need to become mainstream and made more public and available for our members to see. We then worked hard together with a writing group to be sure we voiced all of the appropriate sects in academia and came up with this compelling paper outlining, in detail, the issues facing the future of our profession."

With heart disease remaining the number one cause of death in the U.S., and 40 percent of Americans developing some form of cardiovascular disease by 2030, the hope is that these recommendations will be taken seriously, as the need for skilled academic cardiologists will only grow in the coming years."If changes aren't made soon, the very foundations of academia could begin to crumble," adds Freeman.